Research Mentor Name
Research Mentor Email Address
Institution / Department
Cedars-Sinai Medical Center
Level of Research
MITRACLIP IN THE SETTING OF CARDIOGENIC SHOCK: BEYOND COAPT
Deen, James, MS., Lev, Tohar, BS., Ebinger, Joseph, MD.
Purpose of the study:
To assess the short- and long-term outcomes of patients undergoing MitraClip for severe MR in the setting of cardiogenic shock.
This was a retrospective observational cohort study of patients who underwent MitraClip at large academic institution between 2013 and 2019. Charts were reviewed to identify patients with pre-procedure cardiogenic shock if at least 1 of the following was present: 1) documentation of ongoing cardiogenic shock by a provider, 2) cardiac index <2.2 or 3) use of inotropes (Dobutamine, Milrinone or Dopamine) or vasopressors (Norepinephrine, Epinephrine or Vasopressin) within 24 hours of the procedure.
Out of 448 MitraClip patients, 29 (6.5%) were identified as having pre-procedure cardiogenic shock. Of those in cardiogenic shock prior to MitraClip, 26 (90%) were on inotropes and 16 (55%) were on vasopressors. This decreased to 22 (76%) and 15 (52%) post-procedure, respectively, though did not reach statistical significance (p=0.80). On pre-procedure echocardiography, MR severity was graded as severe or very severe in 21 (72.4%) of those with cardiogenic shock and 301 (71.8%) of those without shock. Of these patients, MR severity was reduced to moderate or less in 26 (89.7%) of those with shock and 400 (95.5%) of those without shock following the procedure (p=0.80).
Use of MitralClip for the treatment of MR in the setting of cardiogenic shock is feasibility, with noted reductions in the severity of MR and inotropic requirements.
Medicine and Health Sciences
Deen, James; Lev, Tohar; and Ebinger, Joseph, "MITRACLIP IN THE SETTING OF CARDIOGENIC SHOCK: BEYOND COAPT" (2020). Medical Student Research Symposium. 38.